Referral pattern of physical diseases in psychiatric in-patients

OBJECTIVE: To study the referral pattern of physical diseases in psychiatric in-patients in a university teaching general hospital.

METHODS: A longitudinal prospective study, over 12 months with a consecutive series of referrals from psychiatric in-patient unit to other specialties, in King Khalid University Hospital, using a predesigned format that included information on age, sex, physical examination on admission, consulted medical specialties and opinion of the consulted physician.

RESULTS: Referral rate was 38% of the total psychiatric in-patients. The most common consulted specialties were endocrinology (14.5%), dermatology (12.5%) and cardiology (12%). About three quarters of the patients were below 30 years of age. Physical examination on admission was not carried out for 16% of cases. Forty-four percent of clinicians responses were within 48 hours of the consultation. There were no responses in 12% of the consultations and no life-threatening physical conditions. About one-third of referred patients were schizophrenics.

CONCLUSION: Physical diseases in psychiatric in-patients are common. Evaluation of psychiatric patients should include a detailed physical examination, thorough medical and psychiatric history, as well as appropriate laboratory testing. Improving psychiatrist trainees’ skills in detecting and assessing physical conditions in psychiatric patients is essential.